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City of Santa ,r -,a <br />Clerk of the Cowicil <br />AGREEMENT TERMINATION FORM <br />Please complete this form when the attached agreement and all <br />amendments (if any) are no longer in effect. <br />Return form to the Clerk of the Council Office (M -30). <br />Call 647 -6520 if you have any questions. <br />The agreement with <br />COTC Office Use Only <br />------------------------------ n... --�. ._ <br />a <br />J, <br />No. � 0/I -% %2 -d .i w <br />ti =as completed on and final payment has been made. <br />(List all amendments. Use space below if needed.) <br />Revised 0 8-2370 <br />Department: <br />cZ) ,- <br />Phone /Ext.: s��l <br />Signature:f <br />Date: <br />